Public Health Grant allocations to local authorities 2024/25: On-the-day briefing, 5 February 2024
Although any real terms increase is positive news, this settlement continues to leave local public health teams with limited resources to maintain essential services such as sexual health services and specialist community public health nursing for the next year
Although any real terms increase is positive news, this settlement continues to leave local public health teams with limited resources to maintain essential services such as sexual health services and specialist community public health nursing for the next year.
It is disappointing that the final Public Health Grant allocations for 2024/25 have been published so late (5 February). With less than two months away from the start of the financial year and councils are only just being formally told how much money is being made available for councils to tackle costly public health issues such as sexual health, drug and alcohol services and stop smoking services.
LGA analysis has found that, between July 2015 and 2024, the Public Health Grant received by councils has been reduced in real terms by £858 million (in 2022/23 prices). This has resulted in reduction in councils’ ability to spend on public health commissioned services.
Public health teams have faced an unprecedented period of funding and demand pressures and continue to face significant pressures and challenges. Sufficient ongoing funding is needed to ensure all local authorities can continue to meet their statutory public health responsibilities. As funding has fallen, councils have focused their spend on meeting their statutory obligations. This has led to a reduction in spend on preventative services and a greater focus on reactive, demand-led provision. This is despite the growing body of evidence of the financial and social benefits of prevention.
Local authority public health interventions funded by the Grant provide excellent value for money. However, we are concerned about the piecemeal nature of some of this. Although one-off pots of funding are helpful in the short-term, long-term clarity is needed if councils are to truly improve health outcomes in their communities.
Services such as local sexual health clinics have seen record demand coupled with staffing shortages. At a time when NHS and social care pressures are greater than ever, vital sexual health, drug, alcohol and health visiting services cannot keep living a hand to mouth existence with insufficient resources to meet this demand.
NHS pay settlements cannot and should not be an additional burden on already pressured council public health budgets. Vital public health services run by councils cannot continue to maximise their role at the heart of communities while continually having to make budget cuts or manage uncosted new burdens. To end this uncertainty, we call on the Government to continue to fund NHS pay rises in full.
We continue to make the case for multi-year settlements and for more long-term certainty around public health funding for all councils. An increased focus on prevention through an uplift to the public health grant is needed, as well as a wider review of the adequacy of public health funding. This will support the Government’s wider aims by improving health outcomes, reducing health spending and putting social care and the NHS on a better footing for the long term.
A coordinated Government wide strategy is required to improve the nation’s health together with a commitment to funding public health properly. It is fiscally sensible to invest in public health to help reduce the long-term cost of treatment and to maintain a sustainable health and social care service.
If the Government provides public health with the long-term resources it needs, this will reduce the long-term cost of treatment on the NHS while maintain a sustainable health and social care system. Such investment will have a greater return than if the same money was spent in the NHS; academic analysis by the University of York shows public health expenditure by councils is three to four times as cost-effective in improving health outcomes delivered by the NHS.
In the financial year 2024 to 2025, the total public health grant to local authorities will be £3.603 billion. The grant will be ring-fenced for use on public health functions.
The finalised allocations for 2024 to 2025 comprise the published indicative allocations for 2024 to 2025 with an uplift for the additional recurrent pay pressures due to the 2023 to 2024 consolidated NHS Agenda for Change pay award.